Low AHI - still tired

eblingus · Post by **eblingus** » Fri Sep 14, 2007 1:14 pm

My first sleep study showed AHI of 7.
My second, with CPAP, showed AHI of 1.1
I have been using the CPAP for six weeks, but except for reducing morning headaches, I do not feel any better or less tired. I sleep for about 6-9 hours per night. As far as I can tell, I am not struggling with any parts of this therapy.

Does that seem odd to anybody besides me? I am not a 'walking dead' person and have rarely felt THAT tired, but just tired all the time. I would like to know if anybody out there has similar situation and experience.

Guest · Post by **Guest** » Fri Sep 14, 2007 4:56 pm

Me too. My AHI is low, but I'm really tired. I really gotta get that software and card reader installed....

Cheers,
Barbara

Murphy · Post by **Murphy** » Fri Sep 14, 2007 5:48 pm

I am also tired all the time and I have been on cpap since April of this year, have not had a hard time adjusting and I always use it and I have the software and my AHI is 2.7. I just started taping my mouth to see if that makes a difference, but so far no.
Eileen

Born Tired · Post by **Born Tired** » Fri Sep 14, 2007 6:20 pm

Some people seem to notice a difference right away, but for some of us it takes time. It took me a year just to find the right mask/machine (with the help of this forum). It was another 6 months or more before I knew I felt less tired--the improvement was very gradual. I still awaken numerous times at night, but overall I am so much less tired now than before I began this adventure.
Hope you start to notice a difference soon.
Esther
--

Snoredog · Post by **Snoredog** » Fri Sep 14, 2007 6:29 pm

drag out your diagnostic PSG, look for non-OSA events that can destroy your sleep architecture like PLMD, RLS and spontaneous arousals.

If you have chronic muscle-skeletal pains like a bad lower back or arthritus, look at that and any medications you may be taking.

Check with your doctor, but you may want to check out supplemental Niacin (vitamin B3), it will help speed up your metabolism and energy.

http://www.pdrhealth.com/drug_info/nmdr ... 0184.shtml

http://en.wikipedia.org/wiki/Niacin

Niacin is available in 500mg dose OTC, but you may want to consider the prescription version Niaspan, it is time-release to reduce flushing (similar feeling to a sun burn).

I have taken both types with doses of up to 2000mg per day under order of my Cardiologist to take that much never could long term but I was being monitored with blood tests for liver damage every 6 weeks, that risk goes way up if you go over 1000mg per day. I do NOT recommend that higher dose in either form. 500mg per day is all you need (in my opinion).

The adverse side effects of flushing and hair standing up on the back of your neck goes away after about the first weeks use. The flushing only lasts about 15 minutes, it lets you know it is working. I take the OTC version from Costco in the 500mg dose. This is about 1/4 of what my doctor prescribed.

If you have problems controlling cholesterol and/or gall bladder problems you may want to explore Niacin, it has been shown to help in both situations.

I take it because it is good for your heart and a poor man's version of Lipitor, many Cardiologists prescribe it to patients.

birdshell · Post by **birdshell** » Fri Sep 14, 2007 6:34 pm

Please do not despair. It can take a long, long time to improve. I have used my CPAP machine faithfully for nearly a year and a half. It would be tough to pinpoint the point at which I felt better. Further, I hope I'm not done yet!

I have described my improvement as "slow, but significant" and it has continued because I felt not-so-great this spring. I had another study (a CPAP study, it is called) which revealed PLMD (periodic limb movement disorder).

Apparently, the SDB (sleep disordered breathing) was masking my PLMD the first two times. (That would be the initial sleep study and the titration done over a year ago.)

So, PLEASE keep with it. It will pay off; not ALL of us are fortunate enough to have the best sleep of our lives during titration!

Click Here for New/Struggling Users

Best wishes,
Karen

Wulfman... · Post by **Wulfman...** » Sat Sep 15, 2007 2:36 pm

For starters......check with your doctor about having an overnight pulse-oximetry study.
It'll tell whether your blood oxygen levels are up-to-snuff.

Den

Another Guest · Post by **Another Guest** » Sat Sep 15, 2007 5:33 pm

I have been on CPAP for 3 plus years and am a ZOMBIE...not a wee bit sleepy sometimes, I am a true ZOMBIE! Not to give you a downer...it does take time to pay off your sleep debt and often up to a year. Also, as an earlier poster pointed out, your AHI may be low yet you may experience arousals (not haivng to come fully awake to have them) from PLMD, fibromyalgia, other underlying problems that were masked by SA, improper REM and in my case my deep sleep, stage 3 is limited and stage 4 is none. I have been retitrated 3 times and have had the MSLT showing Primary CNS Hypersomnia along with the SA. Also, just recently my Dr took a jab and jabbed me with B12 injections. My B12 was within the U.S. limits but low....too early for me to tell but I think it is working...

Good luck...I stopped in from another SA forum.

Mrs. Rip Van Winkle

eblingus · Post by **eblingus** » Mon Sep 17, 2007 3:30 pm

Born Tired wrote:Some people seem to notice a difference right away, but for some of us it takes time. It took me a year just to find the right mask/machine (with the help of this forum). It was another 6 months or more before I knew I felt less tired--the improvement was very gradual. I still awaken numerous times at night, but overall I am so much less tired now than before I began this adventure.
Hope you start to notice a difference soon.
Esther
--

Why did you change masks & machines? How do I know I need to make a change vs. just sticking with it?

eblingus · Post by **eblingus** » Mon Sep 17, 2007 3:36 pm

Snoredog wrote:drag out your diagnostic PSG, look for non-OSA events that can destroy your sleep architecture like PLMD, RLS and spontaneous arousals.

I just checked.
PSG study: No PLMD. 51 spontaneous arousals.
CPAP study: No PlMD. 21 spontaneous arousals.

Snoredog wrote: If you have chronic muscle-skeletal pains like a bad lower back or arthritus, look at that and any medications you may be taking.

I have no other issues, and I am not on any medication, except the sleep aid pills I started with the CPAP.

Snoredog wrote: Check with your doctor, but you may want to check out supplemental Niacin (vitamin B3), it will help speed up your metabolism and energy.

Thanks, I will ask about the Niacin.

eblingus · Post by **eblingus** » Mon Sep 17, 2007 3:38 pm

Wulfman... wrote:For starters......check with your doctor about having an overnight pulse-oximetry study.
It'll tell whether your blood oxygen levels are up-to-snuff.

Den

The PSG study showed O2 of 91-95%, and the CPAP study O2 was 93-97%.

eblingus · Post by **eblingus** » Mon Sep 17, 2007 3:40 pm

Another Guest wrote:...improper REM and in my case my deep sleep, stage 3 is limited and stage 4 is none.

My Stage 4 for both my PSG and CPAP studies were 8% Stage 3 and zero Stage 4.

eblingus · Post by **eblingus** » Mon Sep 17, 2007 3:43 pm

birdshell wrote:Please do not despair. It can take a long, long time to improve.

Thanks.
My issue is how do you decide when to stick with a therapy until it works as opposed to switching masks & machines, having more tests, etc - looking for other solutions?

Another Guest · Post by **Another Guest** » Mon Sep 17, 2007 4:07 pm

Well, first talk to your Dr about what you asked here, also ask about the stage 3 and 4. I hope your Dr is a board certified sleep specialist.I Regular docs do not have the training nor the patient experience to understand it all.

If you are not experiencing mask leaks then it is probably not the mask notr the CPAP IMO. If you do not have a bed partner see if you can video yourself sleeping. Maybe the mask slips during your sleep and you are unaware of it. BTW...what is your CPAP setting?

I think what is most important is to give yourself time (still talk to doc). just not having the headaches alone is showing that it is working. Your SA seems to be in the mild catagory...you may not experience the same "noticeable" relief that a moderate to severe sufferer would. The best way I can explain it...a severe sufferer newly on CPAP would notice a difference the same way a person from a cold dry state would when they fly from their state to Florida. The minute you walk off the plane the humidity hits you...you feel it. A mild SA sufferer would be the same as if that same passenger were to drive to Florida instead...the difference is gradual.

Get a metabolic work up...check for vitamin deficiencies. Make sure the thyroid has been checked and that you are not anemic. I am about day 5 on my B12 injections...can't believe how much better I am feeling...less tired, more alert, better cognitive thinking, no automatic behavior, better mood..the list can go on and on. Again, I hope this was my answer.

No matter what, Stick with the treatment, you will be worse off in the future.

birdshell · Post by **birdshell** » Mon Sep 17, 2007 4:11 pm

eblingus wrote:
birdshell wrote:Please do not despair. It can take a long, long time to improve.
Thanks.
My issue is how do you decide when to stick with a therapy until it works as opposed to switching masks & machines, having more tests, etc - looking for other solutions?

You are more than welcome.

As for your specific question, I am not sure that there is a single answer to that. We are all different. However, I know that I have personally tried using 9 masks in the year and a half that I have been using cpap. I keep looking for the perfect mask for me. However, as my good friend Catnapper said recently, she thinks that she could now use ALMOST any mask for a night or so. I agree.

Machines are another story altogether. Some of the algorithms upon which they run are best for some, others suit some, and some people just do not prefer one over the other. I have a suspicion that many of us are most fond of the machines that resemble our first. That flow generator did, in fact, instigate the first improvement in our xPAP lives (albeit, in conjunction with the mask). We may chuck those masks willy-nilly, but we cannot always afford so many various machines. (Well, except for rested gal Laura...)

After a year, upon having my cpap study, I found that I needed a raise in pressure and medication for PLMD. IF I'd had a data recording machine with the accompanying software, the need for the pressure increase would have been caught sooner.

So, maybe you would like to consider that option? It sounds as if you may be a prime candidate. It requires a bit more time, but can really pay off in figuring out your benefit from the xPAP usage.

One problem, though, is that the software is more difficult to attain. At least, that is what I think I read here.

Since I don't use it, I'm not such a knowledgable resource--but there are MANY others who can help you out!

Best wishes,

Karen

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